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Unexpected manifestation of cardiac amyloidosis
  1. Sauid Ishaq1,2,
  2. Fei Lin1,
  3. Joe Martins3,
  4. Robert Huggett3
  1. 1Department of Gastroenterology and Cardiology, Dudley group of Hospital, Dudley, UK
  2. 2Health and science department, Birmingham City University, Birmingham
  3. 3Department of Cardiology, Dudley Group of Hospital, NHS Trust, Dudley
  1. Correspondence to Professor Sauid Ishaq, Sauid.Ishaq{at}


This report discusses an unusual case of cardiac amyloidosis. We report a patient who presented with unexplained ascites on a background of stable hypertension and mild left ventricular systolic dysfunction, cardiovascular complaints commonly associated with age. Due to the unspecific nature of his cardiovascular symptoms, it took 2 years of recurrent, unresolved ascites, numerous investigations, shifting differential diagnoses and significant cardiovascular deterioration before cardiac amyloidosis was recognised, by which the disease was at end stage. This case emphasises the need for more discriminating clinical features in the diagnosis of cardiac amyloidosis and advocates unexplained, recurrent ascites as a possible candidate.

  • heart failure
  • cirrhosis

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  • Contributors SI, JM and RH were directly involved in the care and treatment of patient. FL wrote the case report, critically reviewed by all coauthors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.